Prolactin response to electroconvulsive therapy: effects of electrode placement and stimulus dosage.

Journal Article


It is unclear whether the serum prolactin (PRL) surge following electroconvulsive therapy (ECT) is a marker of optimal ECT administration. We investigated the relations among PRL surge, stimulus parameters, and outcome in major depressive disorder (MDD).


Seventy-nine patients with MDD were randomized in a double-blind trial to right unilateral (RUL) or bilateral (BL), and to low-dose (just above seizure threshold) or high-dose (2.5 x threshold) ECT.


Change in PRL (delta PRL) varied among treatment groups, with significant effects of electrode placement (BL > RUL, p < .006), electrical dosage (high > low, p < .04), and gender (female > male, p < .005). There was no evidence that clinical improvement was associated with greater PRL surge.


Although delta PRL varied with parameters impacting on response rates, these data indicate the PRL surge cannot serve as a useful index of clinically effective treatment. This finding does not support the view that diencephalic seizure propagation is necessary for ECT to exert therapeutic effects.

Full Text

Duke Authors

Cited Authors

  • Lisanby, SH; Devanand, DP; Prudic, J; Pierson, D; Nobler, MS; Fitzsimons, L; Sackeim, HA

Published Date

  • January 1998

Published In

Volume / Issue

  • 43 / 2

Start / End Page

  • 146 - 155

PubMed ID

  • 9474447

Pubmed Central ID

  • 9474447

Electronic International Standard Serial Number (EISSN)

  • 1873-2402

International Standard Serial Number (ISSN)

  • 0006-3223

Digital Object Identifier (DOI)

  • 10.1016/s0006-3223(97)00222-9


  • eng